Publications by authors named "Myra Cocker"

18 Publications

  • Page 1 of 1

[18F]-Fluorodeoxyglucose PET/CT imaging as a marker of carotid plaque inflammation: Comparison to immunohistology and relationship to acuity of events.

Int J Cardiol 2018 Nov 2;271:378-386. Epub 2018 Jun 2.

Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Radiology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Nuclear Medicine, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address:

Background: [18F]-fluorodeoxyglucose (FDG) uptake imaged with positron emission tomography (PET) and computed tomography (CT) may serve as a biomarker of plaque inflammation. This study evaluated the relationship between carotid plaque FDG uptake and a) intraplaque expression of macrophage and macrophage-like cellular CD68 immunohistology; b) intraplaque inflammatory burden using leukocyte-sensitive CD45 immunohistology; c) symptomatic patient presentation; d) time from last cerebrovascular event.

Methods: 54 patients scheduled for carotid endarterectomy underwent FDG PET/CT imaging. Maximum 18FDG uptake (SUV) and tissue-to-blood ratio (TBR) was measured for carotid plaques. Quantitative immunohistological analysis of macrophage-like cell expression (CD68) and leukocyte content (CD45) was performed.

Results: FDG uptake was related to CD68 macrophage expression (TBR: r = 0.51, p < 0.001), and total-plaque leukocyte CD45 expression (TBR: r = 0.632, p = 0.009, p < 0.001). FDG TBR uptake in carotid plaque associated with patient symptoms was greater than asymptomatic plaque (3.58 ± 1.01 vs. 3.13 ± 1.10, p = 0.008). FDG uptake differed between an acuity threshold of <90 days and >90 days (SUV:3.15 ± 0.87 vs. 2.52 ± 0.45, p = 0.015).

Conclusions: In this CAIN cohort, FDG uptake imaged with PET/CT serves a surrogate marker of intraplaque inflammatory macrophage, macrophage-like cell and leukocyte burden. 18FDG uptake is greater in plaque associated with patient symptoms and those with recent cerebrovascular events. Future studies are needed to relate FDG uptake and disease progression.
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http://dx.doi.org/10.1016/j.ijcard.2018.05.057DOI Listing
November 2018

A single slice measure of epicardial adipose tissue can serve as an indirect measure of total epicardial adipose tissue burden and is associated with obstructive coronary artery disease.

Eur Heart J Cardiovasc Imaging 2014 Apr 9;15(4):423-30. Epub 2013 Oct 9.

Department of Medicine (Cardiology), University of Ottawa Heart Institute, The Ottawa Hospital, 40 Ruskin Street, Ottawa, ON, Canada K1Y 4W7.

Aims: To evaluate the practical use of the single slice measurement of epicardial adipose tissue (EAT) at the level of the left main coronary artery (EATLM) in predicting the presence of obstructive coronary artery disease (CAD).

Methods And Results: Quantification of EATTotal and EATLM was performed on non-contrast CT scans of consecutive patients (without history of revascularization, cardiac transplantation, device implantation, and congenital heart disease) who underwent coronary artery calcium (CAC) scoring and computed tomographic coronary angiography (CTA) between May 2011 and July 2011. One hundred and ninety-two patients were evaluated, of which 47 had obstructive CAD (>50% stenosis). EATLM (3.8 ± 2.2 cm(3)) and EATTotal (126.2 ± 56.3 cm(3)) are highly correlated (r = 0.89, P < 0.001). Multivariate analysis revealed that both EATLM (OR: 1.204 per 1 cm(3), 95% CI: 1.028-1.411, P = 0.021) and EATTotal (OR: 1.007 per 10 cm(3), 95% CI: 1.000-1.013, P = 0.038) are associated with obstructive CAD. However, when the CAC score was added to multivariate analysis, both failed to show statistical significance. (EATTotal, OR 1.004 per 1 cm(3), 95% CI: 0.996-1.011, P = 0.328 and EATLM, OR: 1.136 per 10 cm(3), 95% CI: 0.948-1.362) ROC curve analysis revealed that both EATTotal and EATLM are of incremental value in detecting CAD, when compared with clinical risk scores (NCEP plus EATTotal plus BMI and NCEP plus EATLM plus BMI vs. NCEP alone; AUC 0.7090, P = 0.009 and 0.7167, P = 0.003 vs. 0.6069, respectively).

Conclusion: Measuring epicardial adipose tissue on a single slice at the level of the left main coronary artery may serve as an indirect measure of total epicardial adipose tissue burden. EATLM and EATTotal are independently associated with obstructive coronary artery disease and are incremental to traditional risk factors for predicting its presence.
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http://dx.doi.org/10.1093/ehjci/jet175DOI Listing
April 2014

Cardiac PET: metabolic and functional imaging of the myocardium.

Semin Nucl Med 2013 Nov;43(6):434-48

National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

Cardiac PET has evolved over the past 30 years to gain wider acceptance as a valuable modality for a variety of cardiac conditions. Wider availability of scanners as well as changes in reimbursement policies in more recent years has further increased its use. Moreover, with the emergence of novel radionuclides as well as further advances in scanner technology, the use of cardiac PET can be expected to increase further in both clinical practice and the research arena. PET has demonstrated superior diagnostic accuracy for the diagnosis of coronary artery disease in comparison with single-photon emission tomography while it provides robust prognostic value. The addition of absolute flow quantification increases sensitivity for 3-vessel disease as well as providing incremental functional and prognostic information. Metabolic imaging using (18)F-fluorodeoxyglucose can be used to guide revascularization in the setting of heart failure and also to detect active inflammation in conditions such as cardiac sarcoidosis and within atherosclerotic plaque, improving our understanding of the processes that underlie these conditions. However, although the pace of new developments is rapid, there remains a gap in evidence for many of these advances and further studies are required.
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http://dx.doi.org/10.1053/j.semnuclmed.2013.06.001DOI Listing
November 2013

CT vs SPECT: CT is the first-line test for the diagnosis and prognosis of stable coronary artery disease.

J Nucl Cardiol 2013 Jun;20(3):465-72

Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.

Non-invasive cardiac imaging is pivotal in the diagnosis and prognosis of patients with stable CAD. Nuclear SPECT, PET, stress echocardiography and more recently cardiac magnetic resonance imaging have been utilized with excellent diagnostic accuracy. However, along with their inherent individual limitations, most modalities detect ischemia but lack the ability to define coronary anatomy or evaluate for subclinical atherosclerosis. A modality that not only accurately diagnoses obstructive CAD and also facilitates early identification of non-obstructive CAD may be of interest because it may allow for earlier aggressive risk factor modification and primary prevention. Cardiac computerized tomographic angiography (CCTA) has the potential to accurately detect or exclude luminal stenosis, as well as identify and quantify subclinical atherosclerosis in the absence if luminal narrowing. However CCTA, being a relatively a new modality, has less supporting evidence when compared to more mature modalities such as SPECT. Therefore, the question that begs to be addressed is whether CCTA can be utilized as a first line test in establishing the diagnosis and prognosis of CAD.
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http://dx.doi.org/10.1007/s12350-013-9690-6DOI Listing
June 2013

Predictive value of cardiac computed tomography and the impact of renal function on all cause mortality (from Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes).

Am J Cardiol 2013 Jun 15;111(11):1563-9. Epub 2013 Mar 15.

Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

Patients with chronic kidney disease have a worse cardiovascular prognosis than those without. The aim of this study was to determine the incremental prognostic value of coronary computed tomographic angiography in predicting mortality across the entire spectrum of renal function in patients with known or suspected coronary artery disease (CAD). A large international multicenter registry was queried, and patients with left ventricular ejection fraction (LVEF) and creatinine data were screened. National Cholesterol Education Program Adult Treatment Panel III risk was calculated. Coronary computed tomographic angiographic results were evaluated for CAD severity (normal, nonobstructive, or obstructive) and an LVEF <50%. Patients were followed for the end point of all-cause mortality. Among 5,655 patients meeting the study criteria, follow-up was available for 5,572 (98.9%; median follow-up duration 18.6 months). All-cause mortality (66 deaths) significantly increased with every 10-unit decrease in renal function (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.07 to 1.41). All-cause mortality occurred in 0.33% of patients without coronary atherosclerosis, 1.82% of patients with nonobstructive CAD, and 2.43% of patients with obstructive CAD. Multivariate Cox proportional-hazards models revealed that impaired renal function (HR 2.29, 95% CI 1.65 to 3.18), CAD severity (HR 1.81, 95% CI 1.31 to 2.51), and an abnormal LVEF (HR 4.16, 95% CI 2.45 to 7.08) were independent predictors of all-cause mortality. In conclusion, coronary computed tomographic angiographic measures of CAD severity and the LVEF provide effective risk stratification across a wide spectrum of renal function. Furthermore, renal dysfunction, CAD severity, and the LVEF have additive value for predicting all-cause death in patients with suspected obstructive CAD.
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http://dx.doi.org/10.1016/j.amjcard.2013.02.004DOI Listing
June 2013

Current and future clinical applications of cardiac positron emission tomography.

Circ J 2013 12;77(4):836-48. Epub 2013 Mar 12.

National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario,Canada.

Nuclear imaging, predominantly with single-photon emission tomography, has established and demonstrated value for the assessment of cardiovascular disease (CVD). Formerly, the clinical application of positron emission tomography (PET) was precluded by methodological complexity, high operating costs and lack of widespread availability. However, as PET and radiotracer development technologies have improved and continue to do so, PET is expected to become a mainstay diagnostic cardiovascular imaging modality. Not only is PET imaging of great importance for routine clinical decision-making and diagnosing CVD, it is also gaining prominence in fundamental and translational research models. The scope of this review is to summarize the state-of-the-art advances in PET imaging methodology, clinical utility and potential future application.
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http://dx.doi.org/10.1253/circj.cj-13-0213DOI Listing
September 2013

Identifying high-risk asymptomatic carotid stenosis.

Expert Opin Med Diagn 2012 Mar 17;6(2):139-51. Epub 2012 Feb 17.

University of Western Ontario, Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute , London , Canada.

Introduction: With more intensive medical therapy, the risk of stroke in patients with asymptomatic carotid stenosis (ACS) is now below the risk of carotid endarterectomy or stenting (intervention); ∼ 90% of patients would be better with only medical therapy. It is important, therefore, to have methods to identify the ∼ 10% of patients who stand to benefit from intervention.

Areas Covered: We review the evidence that the risk of asymptomatic stenosis is now below the risk of intervention, and evidence for several approaches to identifying high-risk ACS: transcranial Doppler embolus detection, echolucency and neovascularity on ultrasound, ulceration on three-dimensional ultrasound, plaque composition on magnetic resonance imaging (MRI), plaque inflammation on positron emission tomography and assessment of cerebral blood flow reserve.

Expert Opinion: Carotid endarterectomy or stenting should be performed only in patients with ACS if they have microemboli on transcranial Doppler, three or more ulcers detected on three-dimensional ultrasound or other features of unstable plaque such as plaque echolucency on ultrasound, intraplaque hemorrhage detected on MRI, inflamed plaques detected on PET/CT or reduced cerebral blood flow reserve. Most patients with ACS (∼ 90%) would be better off with intensive medical therapy than with intervention.
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http://dx.doi.org/10.1517/17530059.2012.662954DOI Listing
March 2012

Detection of papillary muscle infarction by late gadolinium enhancement: incremental value of short-inversion time vs. standard imaging.

Eur Heart J Cardiovasc Imaging 2013 May 18;14(5):495-9. Epub 2012 Oct 18.

Division of Cardiology, Department of Heart and Lung, University Hospital of Parma, Via A. Gramsci 14, 43100, Parma, Italy.

Aims: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can detect myocardial scar in patients with myocardial infarction. The detection of papillary muscle infarction (PMI) may be difficult due to the bright blood signal. The aim of our study was to evaluate the incremental value of LGE CMR imaging using an inversion recovery (IR)-GRE with a short-inversion time (TI) over standard LGE imaging in identifying PMI.

Methods And Results: Fifty-six patients with myocardial infarction were studied using a standard IR-GRE LGE sequence with an adjusted TI to null the signal intensity of normal myocardium and with a 3D IR-GRE with a short TI (<180 ms). Signal-to-noise and contrast-to-noise ratios (CNR) and the frequency of PMI were determined. Image quality and infarction sharpness were evaluated. The short-TI LGE sequence detected a higher number of PMI compared with standard LGE sequence (19/54 vs. 15/54) with an increased sharpness of PMI (84.2 vs. 53.3%). The CNR was higher between infarcted myocardium and blood (77.9 ± 60 vs. 19.3 ± 16, P < 0.001) and between PMI and blood (69.4 ± 51 vs. 39.4 ± 26, respectively, P = 0.0157).

Conclusions: Our data indicate that in patients with myocardial infarction, LGE CMR imaging using a short TI may be more sensitive than standard LGE imaging for the detection of PMI.
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http://dx.doi.org/10.1093/ehjci/jes210DOI Listing
May 2013

Imaging atherosclerosis with hybrid [18F]fluorodeoxyglucose positron emission tomography/computed tomography imaging: what Leonardo da Vinci could not see.

J Nucl Cardiol 2012 Dec;19(6):1211-25

Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.

Prodigious efforts and landmark discoveries have led toward significant advances in our understanding of atherosclerosis. Despite significant efforts, atherosclerosis continues globally to be a leading cause of mortality and reduced quality of life. With surges in the prevalence of obesity and diabetes, atherosclerosis is expected to have an even more pronounced impact upon the global burden of disease. It is imperative to develop strategies for the early detection of disease. Positron emission tomography (PET) imaging utilizing [(18)F]fluorodeoxyglucose (FDG) may provide a non-invasive means of characterizing inflammatory activity within atherosclerotic plaque, thus serving as a surrogate biomarker for detecting vulnerable plaque. The aim of this review is to explore the rationale for performing FDG imaging, provide an overview into the mechanism of action, and summarize findings from the early application of FDG PET imaging in the clinical setting to evaluate vascular disease. Alternative imaging biomarkers and approaches are briefly discussed.
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http://dx.doi.org/10.1007/s12350-012-9631-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510422PMC
December 2012

Stress-induced cardiomyopathy: a syndrome of the susceptible patient?

Expert Rev Cardiovasc Ther 2012 Mar;10(3):271-3

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http://dx.doi.org/10.1586/erc.12.9DOI Listing
March 2012

Comparison of long and short axis quantification of left ventricular volume parameters by cardiovascular magnetic resonance, with ex-vivo validation.

J Cardiovasc Magn Reson 2011 Aug 11;13:40. Epub 2011 Aug 11.

Stephenson Cardiovascular MR Centre at Libin Cardiovascular Institute of Alberta, Departments of Cardiac Sciences and Radiology, University of Calgary, AB, Canada.

Background: The purpose of the study was to compare the accuracy and evaluation time of quantifying left ventricular (LV), left atrial (LA) volume and LV mass using short axis (SAX) and long axis (LAX) methods when using cardiovascular magnetic resonance (CMR).

Materials And Methods: We studied 12 explanted canine hearts and 46 patients referred for CMR (29 male, age 47 ± 18 years) in a clinical 1.5 T CMR system, using standard cine sequences. In standard short axis stacks of various slice thickness values in dogs and 8 mm slice thickness (gap 2 mm) in patients, we measured LV volumes using reference slices in a perpendicular, long axis orientation using certified software. Volumes and mass were also measured in six radial long axis (LAX) views.LV parameters were also assessed for intra- and inter-observer variability. In 24 patients, we also analyzed reproducibility and evaluation time of two very experienced (> 10 years of CMR reading) readers for SAX and LAX.

Results: In the explanted dog hearts, there was excellent agreement between ex vivo data and LV mass and volume data as measured by all methods for both, LAX (r² = 0.98) and SAX (r² = 0.88 to 0.98). LA volumes, however, were underestimated by 13% using the LAX views. In patients, there was a good correlation between all three assessed methods (r² ≥ 0.95 for all). In experienced clinical readers, left-ventricular volumes and ejection fraction as measured in LAX views showed a better inter-observer reproducibility and a 27% shorter evaluation time.

Conclusion: When compared to an ex vivo standard, both, short axis and long axis techniques are highly accurate for the quantification of left ventricular volumes and mass. In clinical settings, however, the long axis approach may be more reproducible and more time-efficient. Therefore, the rotational long axis approach is a viable alternative for the clinical assessment of cardiac volumes, function and mass.
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http://dx.doi.org/10.1186/1532-429X-13-40DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169477PMC
August 2011

A new approach towards improved visualization of myocardial edema using T2-weighted imaging: a cardiovascular magnetic resonance (CMR) study.

J Magn Reson Imaging 2011 Aug;34(2):286-92

Stephenson CMR Centre at the Libin Cardiovascular Institute, University of Calgary, Department of Cardiac Sciences, Foothills Hospital, Calgary, Alberta, Canada.

Purpose: To compare T2-weighted cardiovascular magnetic resonance (CMR) imaging with AASPIR (asymmetric adiabatic spectral inversion recovery) and STIR (short T1 inversion recovery) for myocardial signal intensity, image quality, and fat suppression.

Materials And Methods: Forty consecutive patients (47 ± 16 years old) referred by cardiologists for CMR-based myocardial tissue characterization were scanned with both STIR and AASPIR T2-weighted imaging approaches. Signal intensity of left ventricular myocardium was normalized to a region of interest generating a signal-to-noise ratio (SNR). In six patients with regional edema on STIR the contrast-to-noise ratio (CNR) was assessed. Two independent observers used a scoring system to evaluate image quality and artifact suppression. Six healthy volunteers (three males, 32 ± 7 years) were recruited to compare fat suppression between AASPIR and STIR.

Results: SNR of AASPIR was greater than STIR for basal (128 ± 44 vs. 83 ± 40, P < 0.001), mid- (144 ± 65 vs. 96 ± 39, P < 0.01), and apical (145 ± 59 vs. 105 ± 35, P < 0.05) myocardium. Improved image quality and greater suppression of artifacts was demonstrated with AASPIR. In patients with regional edema, CNR increased by 49% with AASPIR, while SNR of pericardial fat did not differ (44 ± 39 vs. 33 ± 30, P > 0.05).

Conclusion: Our findings support the implementation of an AASPIR-based approach for T2-weighted imaging due to improved pericardial fat suppression, image quality, and artifact suppression with greater CNR and SNR.
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http://dx.doi.org/10.1002/jmri.22622DOI Listing
August 2011

Cardiovascular magnetic resonance of myocarditis.

Curr Cardiol Rep 2010 Jan;12(1):82-9

Stephenson Cardiovascular Magnetic Resonance Centre, Foothills Hospital, University of Calgary, Special Services Building, Suite 0700, 1403-29th Street NW, Calgary, AB T2N 2T9, Canada.

Within the past decade, cardiovascular magnetic resonance (CMR) imaging has led to unprecedented growth in our understanding of myocarditis. From what began as a diagnostic tool for assessing ventricular function, CMR has transitioned into visualizing changes that occur in myocardial tissue during inflammation, including edema, hyperemia/inflammation, and fibrosis. In terms of research applications, the entire spectrum ranging from subclinical to fulminant myocarditis can be visualized, as well as unmasking myocarditis from other cardiomyopathies. The impact of CMR in clinical applications is best exemplified by recent findings demonstrating that CMR is a leading diagnostic tool and may perhaps even be the method of choice for establishing a diagnosis of myocarditis in Germany. With the advent of an International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis and large-scale multicenter registries on CMR-based visualization of myocarditis, further advances aimed at improving clinical decision making and guiding patient therapy are expected.
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http://dx.doi.org/10.1007/s11886-009-0077-xDOI Listing
January 2010

Edema as a very early marker for acute myocardial ischemia: a cardiovascular magnetic resonance study.

J Am Coll Cardiol 2009 Apr;53(14):1194-201

Stephenson CMR Centre at the Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada.

Objectives: This study was designed to determine whether imaging myocardial edema would identify acute myocardial ischemia before irreversible injury takes place.

Background: Early identification of acute myocardial ischemia is a diagnostic challenge.

Methods: We studied 15 dogs with serial T(2)-weighted and cine imaging at baseline, during transient coronary occlusion of up to 35 min, and after reperfusion in a 1.5-T magnetic resonance imaging system. Late gadolinium enhancement and troponin measurements were used to assess for the presence of irreversible injury. Myocardial water content was measured to assess myocardial edema.

Results: We consistently observed a transmural area of high T(2) signal intensity matching areas with new onset regional akinesia 28 +/- 4 min after experimental coronary artery occlusion. At this time, the contrast-to-noise ratio between the ischemic and remote myocardium had significantly increased from 1.0 +/- 2.0 to 12.8 +/- 9.6 (p < 0.003), which further increased after reperfusion to 15.8 +/- 10.3 (p < 0.004 compared with baseline). Neither myocardial late gadolinium enhancement nor troponin elevation were noted at this time window. Myocardial water content of the ischemic segments was consistently higher (68.9 +/- 2% vs. 67.0 +/- 2%; p < 0.004) than in remote segments and the difference correlated significantly to the contrast-to-noise ratio in T(2) images (p < 0.04).

Conclusions: We provide the first evidence that T(2)-weighted cardiovascular magnetic resonance imaging of edema detects acute ischemic myocyte injury before the onset of irreversible injury. T(2)-weighted cardiovascular magnetic resonance imaging may serve as a very useful diagnostic marker in clinical settings such as unstable angina or evolving infarction.
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http://dx.doi.org/10.1016/j.jacc.2008.10.065DOI Listing
April 2009

Images in cardiology. Cardiac magnetic resonance imaging in Löffler's endocarditis.

Can J Cardiol 2008 Nov;24(11):e89-90

Stephenson Cardiovascular MR Centre, Foothills Medical Centre, Department of Cardiac Sciences, University of Calgary, Alberta.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644547PMC
http://dx.doi.org/10.1016/s0828-282x(08)70203-4DOI Listing
November 2008

Abnormalities in T2-weighted cardiovascular magnetic resonance images of hypertrophic cardiomyopathy: regional distribution and relation to late gadolinium enhancement and severity of hypertrophy.

J Magn Reson Imaging 2008 Jul;28(1):242-5

Department of Cardiac Sciences, Foothills Medical Centre, University of Calgary, 1403-29th Street NW, Calgary, Alberta, Canada.

Purpose: To explore if focal T2 abnormalities accompany late gadolinium enhancement (LGE) lesions in hypertrophic cardiomyopathy (HCM).

Materials And Methods: All studies were performed under the guidelines of the local ethics committee, which approved the study, and a written informed consent was obtained from each subject. We studied 27 patients (24 males, 51 +/- 18 years) with HCM and evidence for myocardial injury as defined by LGE. The following sequences were performed: steady-state free precession (SSFP) (ventricular volumes, mass, and function), T2-weighted triple inversion-recovery spin-echo and inversion-recovery gradient-echo 10 minutes after intravenous (IV) gadolinium-DTPA (late enhancement).

Results: Focal high T2 signal intensity (SI) frequently matching areas of LGE was observed in nine patients (33%). The presence of these abnormalities correlated with more severe left ventricular hypertrophy (1.5 +/- 0.6 vs. 1.0 +/- 0.4 g/cm; P < 0.05).

Conclusion: In this observational study, we identified focal T2 abnormalities in a subgroup of HCM patients. T2 abnormalities are associated with severe left ventricular hypertrophy. This may provide new insights into the mechanisms of focal irreversible injury in HCM and help in managing these patients.
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http://dx.doi.org/10.1002/jmri.21381DOI Listing
July 2008

Myocardial edema is a feature of Tako-Tsubo cardiomyopathy and is related to the severity of systolic dysfunction: insights from T2-weighted cardiovascular magnetic resonance.

Int J Cardiol 2009 Feb 20;132(2):291-3. Epub 2007 Dec 20.

We investigated if myocardial edema is a feature of Tako-Tsubo cardiomyopathy (TTC). Seven TTC patients in the acute phase were studied using cine, T2 and late enhancement cardiovascular magnetic resonance (CMR). A transmural area of high T2 signal was visible involving the mid-anterior wall and apical segments matching the distribution of hypokinesis. CMR-identified edema is a feature of TTC. This may provide insight into the pathophysiology of stress-induced cardiomyopathy and serve as a useful tool for its non-invasive characterization.
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http://dx.doi.org/10.1016/j.ijcard.2007.08.102DOI Listing
February 2009
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